JASON GREEN DO PA NPI 1649726316

NPI Information

JASON GREEN DO PA is a medical specialty clinic center in Deerfield Beach, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JASON GREEN DO PA NPI is 1649726316. The provider is registered as an organization entity type.
The provider Is Doing Business As Green Dermatology & Cosmetic Center.

The provider's business location address is:

260 SW NATURA AVE
SUITE 101
DEERFIELD BEACH, FL
ZIP 33441-026
Phone: (954) 481-0650
Fax: (954) 481-0651

The provider's authorized official is Jason Green .
The authorized official title is Physician/owner and has the following contact phone number (954) 481-0650.

The CLIA number assigned to this NPI record is 10D2123540 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/31/2016 and was last updated on 8/31/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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